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目的探讨螺旋CT(SCT)灌注成像方法在结、直肠癌中的初步临床应用。资料与方法经手术和病理证实的结直肠癌患者37例,术前先行结、直肠肿块范围的平扫,选定靶平面后再行同层动态增强扫描。绘制靶平面中肿瘤组织和靶血管感兴趣区(ROI)的时间密度曲线(TDC)。根据TDC计算癌灶的强化峰值(PH)、对比剂峰值时间(PT)、强化比值(CER)、对比剂平均通过时间(MTT)、癌灶的灌注量(PF)。采用Dukes分期法,将SCT灌注参数与临床病理因素(Dukes分期、浆膜浸润及淋巴结转移)进行比较。结果结、直肠癌癌灶PH值为(29.04±11.93)HU,PT值为(27.26±4.11)s,MTT值为(32.01±4.81)s,CER值为(10.29±3.06)%,PF值为(39.74±10.82)ml·min-1·100g-1。各灌注参数在Dukes分期、浆膜浸润、淋巴结转移中比较差异无显著性意义(P>0.05),PF随着Dukes分期的期别升高有下降趋势。结论SCT灌注成像可反映结、直肠癌的血流灌注状况,有其潜在的临床应用价值。
Objective To investigate the preliminary clinical application of spiral CT (SCT) perfusion imaging in colorectal cancer. Materials and Methods Totally 37 patients with colorectal cancer confirmed by operation and pathology were examined with plain scan of the tumor and colorectum before surgery. Time-density curves (TDCs) were plotted for tumor tissue and target vessel area of interest (ROI) in the target plane. According to TDC, the enhancement peak (PH), contrast peak time (PT), enhancement ratio (CER), mean contrast time (MTT) and perfusion volume (PF) were calculated. The Dukes staging method was used to compare SCT perfusion parameters with clinical pathological factors (Dukes stage, serosal invasion and lymph node metastasis). Results The colorectal cancer was (29.04 ± 11.93) HU, the PT was (27.26 ± 4.11) s, the MTT was (32.01 ± 4.81) s and the CER was (10.29 ± 3.06)%. The PF was (39.74 ± 10.82) ml · min-1 · 100g-1. There was no significant difference in perfusion parameters between Dukes stage, serosal invasion and lymph node metastasis (P> 0.05). PF decreased with the rising of Dukes stage. Conclusion SCT perfusion imaging can reflect the status of blood flow perfusion in colorectal cancer and has potential clinical value.